PDF(Pubmed)
Abstract：
Dowager\'s hump is described as excessive kyphotic curvature in the thoracic spine with a Cobb angle of more than 40 degrees. This case report presents a 61 years old female office clerk who experienced headaches and neck pain for 3 years that extended into her right shoulder and upper chest. She consulted her primary care physician two months before seeing the chiropractor when the neck pain worsened. A diagnosis of cervicalgia related to osteoarthritis was made based on cervical and thoracic X-ray findings. The patient received non-steroid anti-inflammatory drugs (celecoxib and etoricoxib) and stretching exercises at home. At the onset of chiropractic care, radiographs showed loss of cervical lordosis, narrowing at the C4-5, C5-C6, and C6-7 intervertebral disc space with marginal osteophytes. Based on these findings, a working diagnosis of cervicogenic headache was established. After treatment for 9 months, the patient showed improvement in symptoms and function from cervical curve radiographic change and dextro-convexity of the thoracic spine. Avoiding forward head flexion and maintaining correct posture in daily activities will be key mechanisms to prevent the reoccurrence of Dowager\'s hump. The improvement of symptoms following chiropractic therapy has been shown to correlate with radiographic markers of spinal realignment.
摘要：
Dowager的驼峰被描述为胸椎的后凸曲率过大，Cobb角超过40度。该病例报告介绍了一名61岁的女性办公室职员，她经历了3年的头痛和颈部疼痛，并延伸到她的右肩和上胸部。当颈部疼痛恶化时，她在看脊椎按摩师前两个月咨询了她的初级保健医生。根据颈部和胸部X线检查结果，诊断出与骨关节炎有关的颈痛。患者在家中接受非类固醇抗炎药（塞来昔布和依托考昔）和伸展运动。在脊椎按摩疗法开始时，X光片显示宫颈前凸丧失，C4-5，C5-C6和C6-7椎间盘间隙狭窄，边缘骨赘。基于这些发现,建立了颈源性头痛的工作诊断。治疗9个月后，患者表现出颈椎曲线影像学改变和胸椎右凸的症状和功能改善.避免头部向前弯曲和在日常活动中保持正确的姿势将是防止Dowager驼峰再次发生的关键机制。脊椎治疗后症状的改善已被证明与脊柱重新对齐的影像学标记相关。
